Pubdate: Fri, 22 Mar 2002 Source: Shelby Star, The (NC) Copyright: 2002sThe Shelby Star Contact: http://www.shelbystar.com/ Details: http://www.mapinc.org/media/1722 Author: Barry Smith, Star Raleigh Bureau Bookmark: http://www.mapinc.org/find?186 (Oxycontin) TALLEY PLEADS HIS CASE RALEIGH - Supporters and family members of Dr. Joseph Talley filed into a nearly packed board room Thursday and heard the Grover physician testify that he used his best judgment in treating patients with chronic pain. Those same people also heard Fayleen Huffstetler of Cherryville tell the N.C. Medical Board that Talley had prescribed narcotics for her headache pains even after she told him she was a drug addict. The testimony came during the first of what is expected to be three days of hearings before the N.C. Medical Board. Board attorneys have accused Talley of deviating from the accepted and prevailing standards of practicing medicine in the way he treats some patients and prescribes narcotics to them. If the medical board agrees with the allegations, Talley could lose his medical license. The federal Drug Enforcement Administration has already suspended his privileges of prescribing controlled substances and linked the doctor to 23 overdose deaths. After Thursday's hearing, Talley said his attorney had recommended that he no comment on the proceeding. He did express some concern about the situation, however. "I'm scared because so much is at stake," he said. Specifically, board attorneys accuse Talley of failing to perform physical examinations on many patients before prescribing powerful narcotics, failing to order laboratory tests for pain patients, failing to find out if patients had received medications from other doctors and failing to use non-opiate drugs before prescribing opiates. Talley is also accused of failing to insist that patients get all of their prescriptions filled at a single pharmacy so that care could be adequately monitored. And the board's attorneys allege Talley self-prescribed the drug commonly referred to as "Fen-Phen" for obesity. Talley admitted that he used Fen-Phen pills that he had prescribed for his own patients after they decided that they did not want to use them anymore. He said he encouraged them to bring him the extra pills rather than throw them in the wastebasket. But he said he did not realize what he was doing was illegal at the time. "The only thing at stake here was my own health," Talley told the board. Board attorney Bill Breeze put forth a number of patient files that indicated Talley had not given patients a physical examination before prescribing narcotics, including the opioid pain medicine OxyContin. Talley admitted that he did not give physical examinations to some of his patients, although he said he did provide partial physicals at times. He said he had no objection to giving physical exams, but noted that such exams require time. "There's so many things you've got to cover," Talley said. "Something has got to be sacrificed." Talley said that with acute pain symptoms, physical exams might be helpful in determining treatment. "With chronic pain, the yield on a physical exam is extremely low," he said. Ms. Huffstetler said Talley treated her from 1980 until April 2001. She said Talley never gave her a physical exam. "There was no examination," she said. "I don't ever remember him having a stethoscope around his neck." She said that when she first started seeing Talley, she was suicidal and complained of depression, anxiety attacks and migraine headaches. She moved to Georgia in 1986, but continued to keep in periodic phone contact with Talley and would come back to Grover about once every 12 to 18 months for a doctor's visit. She moved back to Cherryville in 2000. Ms. Huffstetler said she was a drug addict and had been in rehabilitation four times and that she had asked Talley not to prescribe narcotics to her because of her addiction. She said that her husband, Roger Huffstetler, died of an OxyContin overdose on April 12, 2001. Talley had prescribed the drug to her husband the previous month, she said. "My husband was seeing him for a second time for kidney stones," she said. She said the two discussed OxyContin and that Roger Huffstetler told Talley he had been taking 40 milligrams of the drug, four times a day. "He got his prescription pad out," she said. "He said, 'I hope you're right, because if you're wrong, they'll send me up the river for this one.'" Under heated cross-examination by Talley's attorney, Robert Clay, Ms. Huffstetler admitted that her husband was already a drug addict before he received the prescription from Talley. She said her husband had been using her narcotics to support his addiction. "You used Dr. Talley, didn't you?" Clay asked. "Probably," Ms. Huffstetler responded. Clay asked her if she didn't beg Talley for a shot to help her with her pain. "Didn't you beg for the shot?" Clay asked. "He was the one with the smarts," Ms. Huffstetler responded. "You were smart enough to lie to him weren't you?" Clay asked. "It doesn't take much smarts to lie," she answered. She then compared her situation to that of a diabetic. "If your children was a diabetic, would you feed them sugar?" she asked rhetorically. Another one of Talley's patients also testified, but in closed session, said Dale Breaden, a spokesman for the Medical Board. He said the patient had requested anonymity. State law allows for closed sessions to protect patient confidentiality. Breeze said he expects to call two more witnesses today. Then Talley's lawyer will present his case. Some people drove to Raleigh to show support for Talley. One of them was John Mende, a Forest City lawyer who has been a patient of Talley's since 1996. He was injured in an accident in 1981. "My previous doctor did nothing," Mende said. He said that because of the severe pain in his leg caused by the injury, he would not be able to walk around today if it were not for Talley. He said the OxyContin prescribed by Talley had helped him. Breaden said the board could make a ruling in the case as early as Monday. - --- MAP posted-by: Jay Bergstrom